Benedette Okonkwo
Palmdale,CA
Summary
Well-trained Clinical Documentation Improvement Specialist and Foreign Medical Graduate skilled in inpatient concurrent and retrospective reviews, clinical quality review audits, and coding accuracy. Focused professional with expertise in assessing medical records for review of physician documentation accuracy and completeness.
Overview
9
9
years of professional experience
1
1
Certification
Work History
Clinical Documentation Specialist
Addison group/Contract
Florida, Tampa
07.2022 - 05.2024
- Conducted clinically based concurrent and retrospective reviews of inpatient medical records to ensure the provider documentation was reflective of the quality of care for the services provided.
- Reviewed charts to assign DRG, and query physicians for specificity, acuity, clinical validation, uncertain diagnosis, conflicting, and procedure clarifications for accurate and complete documentation.
- Conducted thorough medical record reviews to identify MCCs/CCs, PSI, HAC, and incomplete procedure documentation for DRG improvement, patients' length of stay, and optimize the severity of illness and risk of mortality.
- Performed clinical audit of accounts for accurate principal diagnosis and final coded DRG assignment.
- Provided clinical recommendations to ensure clinical documentation completeness and revenue recovery.
- Worked closely with the CDIs and Coders to ensure all MCCs/CC and HCCs documented in the patient’s medical records were captured.
- Performed in-depth higher-level inpatient retrospective reviews of different clients using multiple CDI software and EHRs
- Provided timely information and work output to supervisors and team members.
Clinical Documentation Specialist
Optum360
Northridge
05.2016 - 07.2022
- Perform a detailed review of documentation present in the medical record for inpatient visits to determine diagnoses and procedures as described by the physicians by conducting clinically based concurrent and retrospective reviews of inpatient medical records to assure the documentation is accurately reflective of the quality-of-care outcomes and reimbursement for acute care services provided.
- Initiated capturing of patient safety indicators (PSI) cases in the So-Cal region, audit charts, both concurrently and retrospectively to capture missed opportunities for CC/MCC, Hospital-Acquired Conditions (HAC) cases, possible opportunities for alternative principal diagnosis that would contribute to overall completeness and accuracy of patient's medical record
- Great knowledge of HCC coding and Risk adjustment process to ensure patient comorbidities are clearly and accurately documented by providing physician education to improve documentation
- Assists with audit requests from the CDI director and/or CDI leadership, including auditing of targeted DRGs to avoid denials.; this includes collecting data from the charts for facility pepper reports for Medicare cases to avoid improper payments due to billing, DRG coding, and/or admission necessity issues.
- Participate in evaluating queries sent by CDI staff for accuracy,
completeness, and compliance with best-practice standards by running the CAC Dashboard open queries, reviewing all queries sent by CDI staff prior to discharge and after discharge.
Clinical Documentation Specialist/DRG Validator
Adventist Health System
Roseville, CA
10.2015 - 06.2021
- Conducted clinically based concurrent and retrospective reviews of inpatient medical records to assure the provider documentation is reflective of the quality of care for the services provided.
- Reviewed physician's notes supporting the DRGs assigned for the paid claim.
- Collaborate with Coders for DRG reconciliation to get the accurate DRG assignment to avoid the risk of claim denial.
- Reviewed charts to assign DRG, and query physicians for specificity, acuity, clinical validation, uncertain diagnosis, conflicting, and procedure clarifications for accurate and complete documentation.
- Conducted thorough medical record reviews to identify MCCs/CCs, PSI, HAC, and incomplete procedure documentation for DRG improvement, patients' length of stay, and optimize the severity of illness and risk of mortality.
- Performed reconciliation of accounts for accurate principal diagnosis and final coded DRG assignment.
- Provide physician education to ensure clinical documentation completeness and revenue recovery.
- Applied all regulatory policies, procedures, and standards to maintain compliance.
- Worked closely with the quality department for tracking provider documentation of patient safety indicators and hospital-acquired conditions.
- Assisted in the development of query templates to aid physicians with proper and precise documentation.
Education
Associate of Science - Nursing
Victory College of Nursing
Florida City, FL03-2024
M.D. -
Nnamdi Azikiwe University
Nigeria02.2003
Skills
- Excellent analytical and critical thinking skills
- Excellent communication skills
- Efficient in one-on-one and group physician engagement and education for documentation improvement
- Ability to quickly and accurately analyze data
- Ability to contribute individually as well as collaborate with a team
- Self-motivated and striving for excellence
- Exceptional judgment skills with the ability to prioritize tasks to meet the deadline
- Proficient with Microsoft Word, Excel, PowerPoint, PowerChart, CorroClarity, 3M encoder, Optum360 CAC, 3M 360, Trucode, InterQual, Midas, Webstrat, Cerner, Meditech, CDMP/JATA , Epic, ect
Certification
- Registered Nurse License, 2023
- Certified Clinical Documentation Specialist (CCDS), ACDIS - 2018
- Certified Coding Specialist (CCS), AHIMA-2018
- Clinical Documentation Improvement Practitioner (CDIP), AHIMA-2015
- Educational Commission for Foreign Medical Graduate (ECFMG) Certification/USMLE-2014
- California State Teaching License-2015
Timeline
Clinical Documentation Specialist
Addison group/Contract
07.2022 - 05.2024
Clinical Documentation Specialist
Optum360
05.2016 - 07.2022
Clinical Documentation Specialist/DRG Validator
Adventist Health System
10.2015 - 06.2021
Associate of Science - Nursing
Victory College of Nursing
M.D. -
Nnamdi Azikiwe University
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